To fully understand the array of laser vision correction procedures that are performed, it is important to understand that LASIK and PRK are general terms. It’s like saying someone had abdominal surgery- was it for the gallbladder, the appendix, the spleen, or the intestines? LASIK and PRK (LASIK makes a flap to access the stroma while PRK removes the top skin layer to access the stroma) are just terms of how to access the part of the cornea that doesn’t regrow, the stroma, and machine it with a laser so myopia (nearsightedness), hyperopia (farsightedness), and astigmatism can be eliminated lessening or eliminating the need for spectacle or contact lens correction. Different procedures with totally different quality of vision, different vision and resolution outcomes, on completely different lasers making completely different shapes, can all be grouped under the same LASIK term. In other worlds not all LASIK (or PRK) is the same.
Start with laser systems. In the United States there is no dispute that the Alcon WaveLight EX500 excimer laser system is the best available (along with the FS200 Femtosecond flap making system it comprises the WaveLight Refractive Suite). It is the most flexible, the fastest laser, the most sophisticated and fastest tracking system, ergonomically the most comfortable for the patient and surgeon, and of course the most expensive. The VISX laser system is the second most common, but has not significantly changed in over twenty years and although much less expensive to acquire and use, it simply is nowhere near as sophisticated and flexible as the WaveLight systems.
The is a topographic guided system that corrects not only nearsightedness and astigmatism, but also corrects the biological flaws that exist because human corneas are imperfect and not made in lens factories! The LYRA (Layer Yolked Reduction of Astigmatism) was the first scientific and technical procedure to make a more uniform, more “perfect” cornea to decrease light scatter for vision that has the potential to be better-than-human-normal. This means it can be described as more clear, higher resolution, more vivid, with minimized glare, halos and visual artifacts. This procedure was granted patent number 10,857,032 by the United States Patent Office. Although not FDA approved for hyperopia cases, Dr. Motwani can perform a two-step procedure for hyperopic Contoura LASIK as well. He has published a paper on this.
As above, but in PRK form for cases where a flap is not desired or recommended. Although taking several days to heal vs. overnight, the vision over the long term is the same as Contour LASIK
A specialized procedure which takes Contoura PRK to the next level by also treating the corneal flaws hidden by the top epithelial layer and therefore not measurable even by the topography guided system. This can be used to make virtually perfect corneas in almost any patient. When used to repair corneas it is called the CREATE Protocol (Corneal Repair Epithelium and Topography Enhanced). This procedure was granted patent number 10,857,033 by the United States Patent office.
This is the standard LASIK correction utilizing the hand measured refraction. This is still utilized by many surgeons on the WaveLight lasers as it simpler, less technically demanding for the surgeon, and very reliable with good results.
A procedure similar in some ways to Wavefront Optimized by no longer used by advanced surgeons as being ineffective at creating supranormal vision. Mainly in use on VISX lasers which do not have the capability of topographic guided ablation procedures.
LASIK flaps do not make a difference for vision as long as they are safely and reliably created. Motwani Lasik Institute uses the Alcon WaveLight FS200 femtosecond system as being extremely fast, very safe and effective, does not require the patient to get up and move between machines in the middle of a procedure, and also less stressful for the patient physically.
Dr. Motwani’s research work allows him to fix virtually any poor outcome from a prior LASIK or PRK procedures through laser corneal reconstruction utilizing the CREATE Protocol. These procedures are documented in peer-reviewed research publications, and Dr. Motwani is the one of the leading surgeons in the world in this field.